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ORIGINAL ARTICLE
Introduction
Maintaining a neutral thermal environment is one of the key
physiologic challenges a newborn infant faces after delivery. While
in utero, heat production by the fetus results in a fetal temperature
that is approximately half a degree higher than maternal
temperature.1 After birth, the newborn infant is exposed to a much
different environment. The risk of hypothermia is real and
potentially dangerous. Mechanisms of heat loss prevention range
from the most basic, almost instinctual, interventions (skin-to-skin
contact) to such highly technical interventions as the modern
incubator. This article will review the mechanisms of heat loss
in term and preterm neonates and the evidence behind the
efforts to prevent heat loss.
Sources of heat loss
The sources of heat loss in the neonate are reviewed in detail by
Knobel and Holditch-Davis2 and provide the basis for the discussion
below. There are four basic mechanisms through which heat is
transferred from the newborn to the environment. These include
radiation, conduction, convection and evaporation. All may
Correspondence: Dr RF Soll, Fletcher Allen Health Care, University of Vermont College of
Medicine, 111 Colchester Avenue, Burlington, VT 05401, USA.
E-mail: Roger.Soll@vtmednet.org
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